What to do if you feel suicidal

Suicide is one of the leading causes of death in children and adolescents – but it doesn’t have to be.

If you are considering suicide or self-harm, pausing to take these 5 steps can save your life:

1. Get help!

You need to seek help immediately if you can’t see any solution to your bad feelings besides harming or killing yourself or others. If talking to a stranger seems easier for you, call 1-800-273-TALK or text “CONNECT” to 741741.

2. Know that there is always another solution – even if you can’t see it right now.

Remember that these emotions will pass, no matter how awful you feel now. Many people who have attempted suicide and survived say that they tried it because they felt there was no other solution or way to end their pain.

3. Remember that having thoughts of hurting yourself or others does not make you a bad person.

Depression can make you think and feel things that do not reflect your true character. These are reflections of how much you are hurting.

4. If your feelings are overwhelming, tell yourself to wait 24 hours before taking any action.

This can give you time to really think things through and see if those strong feelings get a tiny bit easier to handle. During this 24-hour period, talk to anyone who isn’t also feeling suicidal or depressed. Call a hotline or talk to a friend or trusted adult. Remember there are likely several solutions to your problem.

5. If you’re afraid you can’t stop yourself, make sure you are never alone.

Even if you can’t talk about your feelings, stay in public places, hang out with friends or family members, or go to a movie — anything to keep from being by yourself and in danger.

Download the Let's Talk Guide and start a conversation about mental health

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What to do if your friend is suicidal

Suicide rarely happens without warning, and you might be in the best position to notice and assist a friend who needs help. Because suicide rarely happens without warning, you may see signs yourself, hear about them secondhand, or see something online in social media. Here are three key things you can do to help a friend who is suicidal:                

1. Do not be afraid to talk to your friend.

Listen to their feelings. Make sure they know how important
they are to you. But, don’t believe you can keep them from hurting themselves
on your own. Preventing suicide will require help from adults.

2.Don’t keep this secret.

Never keep secret a friend’s suicidal plans or thoughts. You
need to speak up to save your friend’s life, even if they ask you to promise
not to tell.

3.Tell an adult.

Don’t wait to talk to your parent, your friend’s parent, your school’s psychologist or counselor, or any other trusted adult. Don’t be afraid that grown-ups won’t believe you or take you seriously. Talk to someone even if you are unsure your friend is suicidal. This is definitely the time to be safe and not sorry!

Download the Let's Talk Guide and start a conversation about mental health

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How to help your child with anxiety

Anxiety is a feeling everyone experiences at some point. In some situations, anxiety can be helpful; it keeps us alert, protects us from danger and helps us notice problems around us. But for some kids and teens, that sense of anxiety grows too strong or too frequent and can get in the way of their normal activities.

One in four adolescents have mild to moderate anxiety, making it the most common mental health disorder among young people, according to the National Institute of Mental Health. It is more common among girls, often overlaps with depression and can be seen even in young children. Because it can look different in each person and may or may not be triggered by a specific event or setting, it can be difficult for parents to recognize at first.

Whatever the symptoms, anxiety can really interrupt day-to-day life for both your child and you. Knowing the symptoms and learning some coping skills can support you in how to help your child with anxiety. 

Common symptoms of adolescent anxiety can include:

  • Feeling overly worried, nervous or afraid
  • Sleep problems
  • Muscle tension
  • Avoiding certain situations
  • Difficulty concentrating
  • Increased heartrate
  • Upset stomach
  • Headaches
  • Irritability
  • Becoming easily tired

Seven tips to help you manage your child’s anxiety:

Help kids recognize their anxiety

Children and teens often don’t know they are anxious. Help them learn how their body responds to feeling worried or fearful; talk through their emotional and physical feelings with them so they can better identify it when it happens again.

Listen and show support

Encourage your child to open up about any fears and worries they have. Even if their fears seem irrational or exaggerated, let them know you care and think that what they feel is important.

Stick to a routine

Schedules and routines create a sense of structure, security and comfort. Try to make things seem normal for your child, even though they may not be.

Praise small accomplishments

Notice when your child follows through with trying something new or approaching something that makes them nervous. Tell them how much you admire them for trying and that trying is key regardless of the outcome.

Notice your own reactions

Pay attention to your own thoughts and feelings during stressful times. Try to stay calm and positive when your child is anxious.

Find treatment for your child

If worry is getting in the way of normal, daily activities, your child may benefit from therapy, counseling or medication. Talk with your doctor to decide what will work best for your family. If you’re having a hard time with your child’s anxiety, it may also help you to seek therapy or counseling, as well.

Get help

If your child expresses thoughts about wanting to harm themselves or is saying unsafe things, call 911 or bring them to the nearest Emergency Department.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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Tips for Kids and Teens on How to Manage Anxiety

Anxiety is a feeling everyone experiences at some point. In some situations, anxiety can be helpful; it keeps us alert, protects us from danger and helps us notice problems around us. But for some kids and teens, that sense of anxiety grows too strong or too frequent and can get in the way of their day-to-day activities, and these tips on how to manage anxiety can help.

One in four adolescents have mild to moderate anxiety, making it the most common mental health disorder among young people, according to the National Institute of Mental Health.

Anxiety can feel different to each person and may or may not seem to be triggered by a specific event or setting.

Whatever the symptom, anxiety can really interrupt your day-to-day life. Knowing what the symptoms are and learning some coping skills can help anxiety feel much more manageable.

Common symptoms of anxiety can include:

  • Feeling overly worried, nervous or afraid
  • Sleep problems
  • Muscle tension
  • Avoiding certain situations
  • Difficulty concentrating
  • Increased heart rate
  • Upset stomach
  • Headaches
  • Irritability
  • Becoming easily tired

Five tips to manage anxiety:

1. Find ways to relax

When you feel anxious, your muscles tense up, your heart rate increases, and your breathing gets shallower. Take deep breaths for a while to try to get your body back to a resting state.

Try This: Pretend your belly is a balloon. Breathe in to make it bigger, then breathe out and watch it shrink. Count slowly to four when you breathe in and then to four when you breathe out.

2. Face your fears

It might sound scary, but facing your fears is proven to help. It’s called exposure, and it involves taking small steps to getting yourself used to things that make you anxious.

Try this: Get the help of a parent or adult you trust and start with something small. They can help guide you through exposure to it until you start to become less anxious. Using the deep breathing exercise above will also help.

3. Take charge of your thinking

The tricky thing about anxiety is that it’s easy to think negative thoughts when you’re anxious. Pay attention to what you are saying to yourself, and avoid thinking negatively, jumping to conclusions or assuming the worst.

Try this: Ask yourself, “What would I tell my friend if they were in this situation?” or try thinking of times you’ve been able to handle a tough problem.

4. Get enough sleep

Anxiety can cause a frustrating cycle. When we’re anxious, it can be hard to sleep. But not getting enough sleep can make us feel more anxious. Try to eliminate the things that keep you awake and focus instead on setting aside some relaxing time before bed.

Try this: Dedicate the hour before bed to quiet time. Stay away from your phone, TV and computer—the bright lights trick your brain into staying awake longer. Try listening to calm music or meditating instead.

5. Get support

You never have to go through anxiety alone. Having people to turn to for support makes a big difference. A therapist, such as a psychologist, social worker or counselor, can help you understand and manage your feelings. This might be through talk therapy (also called Cognitive Behavioral Therapy or CBT), medication or a combination of both.

Always remember to call 911 if you are in a crisis or are feeling like you want to hurt yourself or others. Helplines are available by calling 1-800-273-TALK or texting “CONNECT” to 741741.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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A day in the life of a mental health nurse

The CHOC Children’s Mental Health Inpatient Center is an inpatient psychiatric center exclusively dedicated to the treatment of children ages 3-17 with mental illness who are in immediate risk of hurting themselves or others. It is the only inpatient facility in Orange County that can treat patients younger than 12. Our doctors and care team are all specially trained to treat children and provide the very best patient- and family-centered care 24 hours a day, seven days a week.

During a child’s stay, he or she engages in daily multidisciplinary therapeutic groups and receives individual therapy, family therapy, brief psychological testing and psychiatric care.

In observance of Mental Health Month, follow along for a day in the life of Madeline, a clinical nurse in CHOC’s Mental Health Inpatient Center.

5:15 a.m. – After fighting my snooze button, I wake up, shower, and drink some much-needed coffee.

6:30 a.m. – My cat yells his goodbyes to me as I give him a treat and leave for work. On the way, I vibe out to music to get pumped up for the day. I’ve worked at CHOC for over a year now. Last year, I was accepted into CHOC’s Registered Nurse Residency program. As a new nurse, I felt called to work in a mental health setting. I am beyond proud to stand alongside the brilliant CHOC team on the frontlines of mental healthcare.  

7:00 a.m. – I join my team in our conference room for a daily briefing report. Together, we review any newly admitted patients, our current population of patients, and any safety concerns. One of the ways we keep kids safe is through trauma-informed care. Upon admission, we work with patients and their families to determine any triggering situations or actions the patients may have, and then learn how strong emotions may manifest outwardly; such as pacing, shaking, or becoming very quiet. This information helps us to rapidly identify when patients are struggling and may need extra support or encouragement to utilize their coping skills. One of my favorite environmental adaptations we can provide for patients is our sensory room. It helps stimulate a few of our five senses to help kids cope and be more present in the moment. Sometimes, just hearing the rhythmic movements of the bubbles can be soothing and have a great calming effect.

7:30 a.m. – Once I have an understanding of our environment, I walk the unit to check on the patients. Most are still asleep, so I then look up my patient’s medications, while verifying medication consents. All pediatric psychiatric medications need parental consent obtained by the patient’s psychiatrist.

8:15 a.m. — Our medication room has a barn door, so I can efficiently and safely administer patients’ morning medications, preform a quick mental status check-in, and obtain vitals.

9:30 a.m. — One of my patients is currently taking a new medication. In order to better understand her body’s acceptance and tolerance of the drug, we need to run labs. Before drawing her blood, I numb a small area of her skin using a J-Tip®. During the blood draw, a child life specialist and I help the patient cope by offering her modeling clay and a hide-and-seek activity book.

10:00 a.m. — Throughout the day, our patients are divided into groups based on age to attend group sessions. This creates a structured environment that promotes the development of coping and social skills they can utilize when they go home. The sessions focus on our various themes of the day that can range from problem solving or emotional regulation to nutrition and wellness. These sessions are led by our team of nurses, social workers, child life specialists, plus and art and music therapists. This morning’s group session is focused on gross motor skills. Our group leaders soak up some sunshine in our beautiful outdoor area while supervising patients socializing and joining in on a game of handball.

11:00 a.m. — I sit down with one of my patients to discuss their day so far and check in on any thoughts of self-harm that we can work through together. Afterwards, as part of the patient care team, I meet with that patient’s psychiatrist Dr. Lavanya Wusirika, and social worker Gaby, to discuss the patient’s care plan.

12:30 p.m. – It’s time for the patients to have lunch. Our patients eat together, so I assist with passing out lunch trays and pouring drinks. One of our licensed vocational nurses, Brenda, has become our unofficial DJ, and she plays music during lunch to help create a fun, therapeutic environment.

1:00 p.m. – I receive a call from a patient’s parent. After addressing their questions, I update them on their child’s plan of care, medications and current temperament.

2:00 p.m. – I use my own lunch break to catch up with my coworkers. We spend a lot of time together, and I’m lucky to have such an amazing work family.

3:00 p.m. – It’s time for one of our patients to head home. Upon admission to the unit, our team begins organizing outside resources and planning ways to increase safety and support at home. This information is built upon throughout their stay and is incorporated into an individualized safety and coping plan. After our social workers discuss the plan for home with the patient and their parent, I review current medication information and additional discharge instructions. Staff members and fellow patients send off their peer with warm wishes and words of encouragement.

4:30 p.m. –As a nurse, it’s my turn to lead one of our nursing groups. After the patients participate in a discussion about favorite coping skills and we do a check-in of their current emotions, we follow a painting tutorial to practice our theme of the day, mindfulness.

6:00 p.m. – I spend time updating my patients’ charts, including their mental status assessments and treatment plans. This way our whole team can see the patient’s progress and any concerns.

6:45 p.m. – During daily community meetings, all of our patients join together, and our staff leads a check-in to summarize what has been learned from our theme of the day. Patients take turns sharing their high and low of the day and how we can build on these experiences for tomorrow.

7:00 p.m. – As our night shift nurses arrive, we take turns giving a report of their patient’s day and mental status. We share new triggers that we have learned from the patients as well as new coping skills that were helpful. Knowing how we can best care for patients before, during and after a crisis or stressful situation is fundamental for trauma-informed care. By caring for every patient as a whole, not as a diagnosis or as someone defined by their trauma or maladaptive behaviors, we are able to better understand and care for them.

8:00 p.m. ― Get home and share a delicious meal with my husband. A long hug and many kisses are bestowed unto my cat Boots. The three of us will cuddle up and watch a show before we head to sleep and start again.

Stay Informed about Mental Health

CHOC Children’s has made the commitment to take a leadership role in meeting the need for more mental health services in Orange County. Sign up today to keep informed about this important initiative.

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